Comparative Pharmacology
Head-to-head clinical analysis: CONZIP versus OPANA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CONZIP versus OPANA.
CONZIP vs OPANA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Tramadol hydrochloride (opioid agonist) and acetaminophen (centrally acting analgesic). Tramadol binds to mu-opioid receptors and inhibits serotonin and norepinephrine reuptake; acetaminophen inhibits cyclooxygenase (COX) and activates descending serotonergic pathways.
Mu-opioid receptor agonist; produces analgesia by binding to opioid receptors in the CNS, inhibiting ascending pain pathways and altering pain perception.
100 mg to 300 mg orally once daily with food. Initiate at 100 mg daily and titrate up by 100 mg increments every 4-7 days based on tolerability. Maximum dose 300 mg daily.
5-20 mg orally every 4-6 hours as needed for pain; extended-release tablets: 5 mg orally every 12 hours, titrated up to 20 mg every 12 hours.
None Documented
None Documented
Terminal elimination half-life: 3-4 hours for tramadol, 5-9 hours for M1 metabolite; clinically, dosing interval is 4-6 hours
Terminal elimination half-life is 11-16 hours (mean 14 hours) in adults; prolonged in hepatic impairment (up to 30 hours) and elderly.
~60% renal (unchanged drug and glucuronide conjugates), ~35% fecal
Primarily renal (approximately 90% as conjugated metabolites, 10% unchanged); biliary/fecal elimination accounts for <10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic